ASWB Clinical 5 — Questions and Answers
Question 1: A client with Obsessive-Compulsive Disorder has been avoiding touching doorknobs due to contamination fears. The MOST evidence-based treatment approach is:
- Psychoanalytic therapy to uncover underlying conflicts
- Exposure and Response Prevention (ERP) (Correct answer)
- Supportive counseling to reduce anxiety
- Relaxation training and biofeedback
Correct answer: Exposure and Response Prevention (ERP)
Exposure and Response Prevention (ERP) is the gold-standard behavioral treatment for OCD, involving systematic exposure to feared stimuli while refraining from compulsions.
Question 2: A social worker is seeing a client who abruptly stops a long-term antidepressant. The client reports flu-like symptoms, dizziness, and electric shock sensations. This is most consistent with:
- Serotonin syndrome
- Antidepressant discontinuation syndrome (Correct answer)
- Neuroleptic malignant syndrome
- Medication-induced depressive episode
Correct answer: Antidepressant discontinuation syndrome
Antidepressant discontinuation syndrome occurs after abrupt cessation of certain antidepressants and includes flu-like symptoms, dizziness, and paresthesias often described as 'brain zaps.'
Question 3: Which attachment style in adults is characterized by discomfort with closeness, self-reliance, and dismissiveness of the importance of relationships?
- Anxious-preoccupied
- Fearful-avoidant
- Dismissive-avoidant (Correct answer)
- Secure
Correct answer: Dismissive-avoidant
Dismissive-avoidant attachment involves minimizing the importance of relationships, valuing self-sufficiency, and feeling uncomfortable with emotional closeness.
Question 4: A 35-year-old client presents with grandiosity, racing thoughts, decreased need for sleep, and has spent his life savings in 3 days. Which diagnosis is MOST likely?
- Hypomanic episode
- Manic episode with psychotic features
- Manic episode (Correct answer)
- Cyclothymic Disorder
Correct answer: Manic episode
A manic episode includes elevated or irritable mood plus three or more symptoms such as grandiosity, decreased sleep, and reckless behavior lasting at least one week.
Question 5: A social worker is legally required to break confidentiality without client consent when:
- A client discloses past illegal drug use
- A client makes a credible threat to harm an identifiable third party (Correct answer)
- A client shares embarrassing personal information
- A client admits to a previous undisclosed crime
Correct answer: A client makes a credible threat to harm an identifiable third party
The Tarasoff duty requires clinicians to protect identifiable third parties from credible threats made by clients, which may include warning the potential victim or law enforcement.
Question 6: In cognitive behavioral therapy, a client who believes 'If I make any mistake, I am a total failure' is demonstrating which cognitive distortion?
- Personalization
- Magnification
- All-or-nothing thinking (Correct answer)
- Mind reading
Correct answer: All-or-nothing thinking
All-or-nothing (black-and-white) thinking involves viewing situations in absolute, binary terms with no middle ground, such as equating any mistake with total failure.
Question 7: A social worker is conducting a suicide risk assessment. Which factor would be considered MOST indicative of HIGH lethality?
- Passive ideation without a specific plan
- History of a previous high-lethality attempt (Correct answer)
- Fleeting thoughts of death without intent
- Expressing ambivalence about suicide
Correct answer: History of a previous high-lethality attempt
A prior high-lethality suicide attempt is one of the strongest predictors of future completed suicide and indicates significantly elevated risk.
ASWB Clinical 5
A client with Obsessive-Compulsive Disorder has been avoiding touching doorknobs due to contamination fears.
The MOST evidence-based treatment approach is: